$125 CHRONIC PAIN STUDY - 45 MINS. PHONE & WEBSHARING
IF YOU DO NOT HAVE ONE OF THESE CONDITIONS & AN IMPLANT TO TREAT IT, OR USING BRONCHIAL THERMOPLASTY FOR ASTHMA YOU DO NOT QUALIFY TO PARTICIPATE. VISIT OUR WEBSITE FOR STUDIES ON OTHER TOPICS.


If you have Asthma, Atrial fibrillation, Chronic pain. or Erectile Dysfunction you could qualify to participate. Answer the questions and submit them. We are looking for men and women 18 and older that have either Atrial fibrillation, Chronic pain. or Erectile Dysfunction and have an implanted device or has Asthma and using Bronchial Thermoplasty as an option for treatment...We will contact you for further screening and with more details. Thank you for you interest in this study.


ELITE MARKET RESEARCH TEAM
Phone: 1-(800) 737-5390 ext. 51
www.elitemarketresearchteamnationwide.net

What State do you live in? *
In what CITY do you live? *
Your answer
What is your FIRST & LAST NAME? *
BOTH NAMES ARE NEEDED
Your answer
What is your phone number? *
Your answer
What is your email address? *
Your answer
What is your age? *
Your answer
What is your gender? *
What is your ethnicity/race?
Do you, or does anyone in your household, work for any of the following? *
Required
For which of the following conditions are you currently under the care of a medical doctor? *
And how long have you had each condition? *
Your answer
In the past 3 months, which, if any, of the following sources have you consulted, read, or used to learn about your health conditions? *
Required
Which of the following companies, if any, have you ever heard of as makers of medical devices that can treat health conditions like yours? *
Required
Have you ever been treated by any implantable devices from these companies? Please select any that apply. *
Required
Which of the following electronic devices do you personally use during the course of a typical day? *
Required
Please read statement below and answer yes or no. *
If you are selected to participate in this confidential interview, you will be asked to talk about your healthcare experiences in detail surrounding the diagnosis and treatment of the conditions you were asked about in this survey.
THIS IS A 2 PART QUESTION: ....PART 1 -If you could give one piece of advice to people living with your health conditions, what would it be? PART 2 - Why? *
REMEMBER THIS IS A 2 PART QUESTION. DON'T FORGET TO ANSWER THE "WHY"?
Your answer
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